Question

An OTA is giving an inservice training on Medicare reimbursement guidelines for DME. In what scenario would medicare approve DME?

A). Sock aid for a pt following a THR
B). Grab bars in the bathroom for a person who cannot bath or toilet without hand support
C). A walker for a person who cannot ambulate in the home I
D.) A reacher for a 7 year child who is unable to reach the top shelf.

Answer 1

Medicare would approve DME such as a walker for a person who cannot ambulate in the home, as it is deemed medically necessary and is used within the patient's residence.

Step-by-step explanation:

Medicare would approve a walker for a person who cannot ambulate in the home. This is considered medically necessary equipment to aid in mobility within the household.

Medicare's guidelines for Durable Medical Equipment (DME) coverage require that the equipment must be medically necessary, prescribed by a doctor, and intended for use in the patient's home. In the scenarios provided, a walker (Option C) meets these requirements because it directly assists a patient in ambulation within their home environment, which is essential for performing daily living activities.

On the other hand, while a sock aid (Option A) and grab bars (Option B) can provide aid in daily tasks following a total hip replacement and to someone unable to bathe or toilet without hand support respectively, these items are not typically covered as they are not considered medical equipment by Medicare standards. Similarly, reachers (Option D) are generally not covered for use by children or adults as they are not classified under medically necessary DME.